Macular Hemorrhage: Should You Rely on One Eye?

Is it advisable to use the affected eye more frequently after a macular hemorrhage has formed a scar?

Hello, Doctor.
I would like to ask you a question.
I have bleeding in my right eye that has scabbed over, and when I look at things with just my right eye, they appear distorted and my vision is poor.
My left eye has dry macular degeneration, but I can see normally with it.
When I look at things with both eyes, the angle and clarity are the same as when I look with just my left eye, and I am not affected by the poor vision in my right eye.
Does this mean that my brain has automatically started to rely solely on my left eye for vision? Will this cause my right eye to deteriorate, leading to worsening vision or possibly optic nerve degeneration? If so, should I train myself to regularly use my right eye to stimulate it?
P.S.
My left eye has a visual acuity of 1.0, while my right eye has myopia of -1.00 and astigmatism of -0.75.
However, since I can see clearly with both eyes together, I don't have any issues.
I am concerned that over time, this might increase the burden on my left eye.
The optician suggested that I could get glasses for my right eye only.
Although my right eye's vision is still poor, at most 0.6, it is still somewhat better.
Is this recommendation reasonable? I feel uncomfortable wearing glasses, and the optician said that because of the correction, my right eye is starting to engage in vision, whereas before, it was only my left eye that was doing the work.
Does this explanation make sense? I find that wearing glasses makes my eyes feel more fatigued.

Additionally, I would like to ask the doctor if bleeding in the macula necessarily indicates the presence of abnormal new blood vessels.
I have seen several doctors who said that it has already scabbed over, but it does not appear to be the type of bleeding associated with new blood vessel formation.
Thank you for your assistance with these questions.

Anita, 30~39 year old female. Ask Date: 2018/09/20

Dr. He Jianxian reply Ophthalmology

In your case, there is no issue of monocular degeneration, as the visual nerve network in adults is already established and fixed, so there is no "use it or lose it" phenomenon.
Since you feel uncomfortable wearing glasses, it is fine not to wear them.
Your right eye's macula has already formed a scar and there are no signs of neovascularization, so there should be no risk of bleeding.
Please rest assured.

Reply Date: 2018/09/20

More Info

Understanding macular hemorrhage and its implications on vision can be quite complex, especially when dealing with conditions that affect one eye more than the other. Based on your description, it seems that you have experienced a significant issue with your right eye, which has undergone hemorrhage and has since formed a scar. Your left eye, while affected by dry macular degeneration, still maintains good vision.
When you mention that using both eyes together provides a similar visual experience as using just your left eye, it suggests that your brain is indeed favoring the input from your left eye. This phenomenon is known as "visual dominance," where the brain relies more on the information received from one eye, especially when the other eye is compromised. This does not necessarily mean that your right eye will deteriorate further due to lack of use, as the brain's visual pathways are quite adaptable. However, if the right eye is not being stimulated adequately, there is a possibility of some degree of visual decline over time, a concept often referred to as "use it or lose it."
To address your concerns about potential deterioration of your right eye, it is essential to engage in some form of visual stimulation. This could involve exercises that encourage you to use your right eye more frequently, even if it is not as clear as your left. However, it is crucial to do this under the guidance of an eye care professional, as they can provide tailored exercises that suit your specific condition.

Regarding the suggestion from the optician to wear glasses that correct your right eye, even if the vision is not perfect, this advice is generally reasonable. Wearing corrective lenses can help provide some level of visual input to the right eye, which may assist in maintaining its function. The discomfort you feel while wearing these glasses could be due to the adjustment period your brain and eyes need to adapt to the new visual input. It is not uncommon for individuals to experience some discomfort when their visual system is adjusting to new corrections, especially when there is a significant difference in the prescription between the two eyes.

As for your question about whether macular hemorrhage is always associated with abnormal new blood vessel growth, it is important to note that not all cases of macular hemorrhage involve neovascularization (the formation of new blood vessels). In some instances, hemorrhage can occur due to other factors, such as trauma, retinal vein occlusion, or even systemic conditions like hypertension or diabetes. If your doctors have confirmed that the hemorrhage has healed and there are no signs of new blood vessel growth, this is a positive indication that your condition may not be as severe as initially feared.

In summary, while your left eye is currently compensating for the right, it is essential to maintain some level of stimulation for the right eye to prevent potential deterioration. Wearing corrective lenses, even if they are not perfect, can be beneficial. Additionally, regular follow-ups with your eye care provider are crucial to monitor your condition and make any necessary adjustments to your treatment plan. If you experience any new symptoms or changes in your vision, do not hesitate to seek medical advice promptly.

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